Provider Demographics
NPI:1578151155
Name:HEALOGY COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:HEALOGY COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDN
Authorized Official - Middle Name:
Authorized Official - Last Name:HABTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-408-5049
Mailing Address - Street 1:15017 N DALE MABRY HWY # 1048
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15017 N DALE MABRY HWY # 1048
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-1816
Practice Address - Country:US
Practice Address - Phone:407-349-7103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty